| NPI | 1710388251 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAHJAHAN SULTAN Physician / Registered Agent 228-215-1004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MS 21500) |
| Enumeration Date | 2014-09-15 |
| Last Update Date | 2014-09-15 |